State never examined Castro Valley senior homeowner's dismal record

CASTRO VALLEY -- To state officials, Herminigilda "Hilda" Manuel was a blank slate when she applied for a license six years ago to run a pair of assisted living homes, one of which is now the subject of a criminal investigation for leaving a dozen frail residents without proper care last month.

Had those officials only bothered to check, they would have discovered much worth knowing. Years earlier, Manuel had a disastrous stint running four Bay Area nursing homes: more than $800,000 in penalties owed a federal health watchdog, health citations for negligent care -- some involving the deaths of residents or the use of physical restraints as discipline -- and a trail of angry workers, elders and their loved ones.

"There was a lot of mess going on, a whole lot of mess going on," said Minnie Everett, 69, whose mother ran into problems at Castro Valley's Sacred Heart Convalescent Hospital in the late 1990s. "The state came in. ... They said they could never open up another place nowhere."

Manuel lost all four nursing homes, the last in December 2001, because of financial problems her lawyer says stemmed from unfair scrutiny from the state. She has remained mired in financial trouble, including a huge overdue tax bill to the federal government.

In May 2013, the Department of Social Services sought to revoke the assisted-living facilities' licenses and ban Hilda Manuel and her daughter, Mary Julleah Manuel, from ever running a home again. The state forced the closure of Valley Springs on Oct. 24. Emergency crews evacuated a dozen residents who had been left with minimal care two days later.

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Interview process

The past dealings with the state did not come up when Hilda Manuel appeared before the Department of Social Services in 2007 and 2008 seeking licenses to run two senior care homes: Eden Manor in Oakland and Valley Springs Manor in Castro Valley. She sailed through the interview and application process. She later added a third home in Modesto in 2012.

Because assisted living homes are for people healthy enough not to require constant medical care, they are monitored by California's social services agency and not its public health care agency, which oversaw the nursing homes Manuel ran earlier. There is no indication in documents reviewed by this newspaper that the social services agency cross-checked the health agency's records.

The documents indicate that Manuel gave some false information in her signed application form. She checked the "no" boxes when asked if she ever had a license for or owned a "health facility." She also left blank a question about past disciplinary action.

But Manuel was clear about her past in another part of the same form asking about her work experience: She described herself as the president of a skilled nursing home facility from 1990 to 2002.

Department of Social Services Director Will Lightbourne declined to comment, and a spokesman, Michael Weston, said, "I'm not going to be able to get into any details about Herminigilda" because of ongoing legal actions against her.

Among the nearly 500 pages in the two assisted living homes' public case files is a checklist that said "the licensing agency will research to determine if the applicant is subject to disciplinary action" at previously licensed facilities.

But even if officials did find out about her record, Weston said, a voluminous history of documented health violations might not have counted as disciplinary action excluding her from a new license.

Her longtime lawyer, Orrin Grover, agreed. "There wouldn't be anything to ask her. There was no license revocation or adverse license revocation" of her nursing homes, he said.

However, there was a mountain of citations and fines.

Buying nursing homes

Manuel bought her first nursing home, in Oakland's Fruitvale district, in 1991, renaming it from the St. Bernadette Convalescent Hospital to the Immaculate Care Center, according to property and business records. She later acquired two more: Wisteria Care Center in Castro Valley and Milpitas Care Center in Milpitas.

Her credentials included a medical technician's degree from a university in her native Philippines and a desire to care for elders, said Grover, who began representing her about 2000. It was only after the 1996 acquisition of her fourth nursing home, Sacred Heart Convalescent Hospital, that problems became apparent. The home racked up 186 state health deficiencies in 1997 and 131 in 1998, including a $9,000 fine for a resident who developed bed sores after being left in her own urine and feces, according to a 1999 investigation by this news organization.

Sacred Heart was the only one of the four homes with a unionized workforce, and Grover said Manuel's refusal to sign a contract led to workers encouraging residents to report complaints to state inspectors.

"After being harassed by the state for 2½ years, she was having financial problems dealing with reimbursement and those kinds of things," Grover said.

Manuel in late 1998 handed over Sacred Heart to a third party, and a court-appointed receiver closed the facility. A provider of therapeutic services sued Manuel for unpaid bills. Manuel sued the lawyers who had been defending her firm.

State and federal health officials also began investigating her other two homes. Among the gravest citations was a $25,000 state fine against the Milpitas home for improper care leading up to a woman's fatal fall. The federal Department of Health and Human Services also documented deficiencies that "posed immediate jeopardy to residents' health and safety" at Wisteria Care Center in August 1998.

Among the violations: Residents were restrained physically or with drugs as a means of discipline or convenience in violation of federal law; residents were given unnecessary drug treatments; and the facility had medication error rates of 5 percent or more.

The federal Centers for Medicare and Medicaid Services terminated its provider agreement with both homes in 1999 -- preventing Manuel's business from taking in any more Medicare patients -- and issued $185,150 in penalties for Wisteria and another $678,750 on the Milpitas facility.

In 2007, the federal government sent Manuel a letter stating that her firm now owed $1,030,200.

"It's kind of a crazy world," Grover said. "The corporation doesn't have any income, it doesn't have any assets. How would it pay them back?"

Her collapsing nursing home empire was just one of the problems confronting Manuel. She and her husband also were embroiled in a legal battle with their partner in a seafood shipping company. U.S. tax court records show the Manuels failed to pay more than $600,000 in personal income taxes through the years, and the courts have determined their actions amount to fraud.

Manuel entered the assisted living business in 2007 and 2008, with Mary Julleah Manuel and several other business partners. However, problems soon cropped up.

The owners never informed Alameda County planners that they took over Valley Springs. They were operating on an expired use permit, which is illegal, according to Toni Henninger, a county code enforcer who recently issued $850 in fines against the home.

Among the myriad actions that ran afoul of state law while Manuel oversaw the homes were repeat incidents of staff at all three homes working without criminal record clearance, problems with record keeping -- 18 Valley Springs residents in October had no paperwork at all -- and persistent understaffing that led to unsafe and dirty conditions and moldy food.

The state cited Valley Springs Manor for not reporting or getting treatment for a resident who suffered a head injury in January 2011, "instead sending the client to a day program bleeding and in a vegetative state."

Financial troubles also mounted as Eden Manor, the Oakland home, fell into foreclosure last year. The Manuels relocated residents in mid-January from Eden Manor to Valley Springs, "falsely informing the clients they had no choice but to move," according to Social Services reports. New owners took over the Oakland home in March.

The accusations and legal proceedings have worsened the already poor health of Hilda Manuel, her lawyer said, including a painful kidney and liver disease that causes her to be bedridden 80 percent of the time.

"About a month before the facility was closed, she was there trying to deal with things and she collapsed. She was so weak she fell down on the floor," Grover said.

Asked if she would try to run another home in the future, Grover said that was unlikely.

Oversight gap

When Herminigilda "Hilda" Manuel applied to the Department of Social Services to run Castro Valley and Oakland assisted living homes in 2007 and 2008, a checklist attached to her application stated that "if the applicant previously held a license for a facility, the licensing agency will compare the Applicant Information Form and verify that the applicant is not subject to disciplinary action (and) if the applicant previously held a license, held a beneficial ownership of 10 percent or more or was an administrator, general partner, corporate office or director of a licensed facility, the licensing agency will research to determine if the applicant is subject to disciplinary action."But state workers apparently never researched her long history owning four nursing homes.